Aim: The recommended treatment for locally advanced gastroesophageal adenocarcinoma has changed to a multimodal approach including neoadjuvant chemotherapy. The aim of this study was to assess potential associations between response to neoadjuvant therapy and post-operative morbidity in patients... Read more

Aim: The recommended treatment for locally advanced gastroesophageal adenocarcinoma has changed to a multimodal approach including neoadjuvant chemotherapy. The aim of this study was to assess potential associations between response to neoadjuvant therapy and post-operative morbidity in patients with gastroesophageal adenocarcinoma. Methods: Sixty-one patients undergoing surgical resection of gastroesophageal adenocarcinoma following neoadjuvant chemotherapy were analyzed. Patients were dichotomized into histopathological responders (Becker grade Ia-II, n = 37) and nonresponders(Becker grade III, n = 24). Perioperative complications were assessed according to the Clavien-Dindo classification. An association between response to neoadjuvant chemotherapy and surgical complications was evaluated with the chi-square or Fisher test where appropriate. Results: Twenty over thirty-seven responders (54.1%) and 17/24 non-responders (70.8%) had perioperative complications of any grade (P = 0.19). The most frequent complications were anastomotic leakage, which had a higher incidence among non-responders (4/24; 16.7%) than responders (1/37; 2.7%; Fisher’s test: P = 0.07); and pulmonary complications, which showed no difference in incidence between non-responders (11/24; 45.8%) and responders (13/37; 35.1%; P = 0.57). Conclusion: In patients undergoing resection of gastroesophageal adenocarcinoma after neoadjuvant chemotherapy, there was no association between response and incidence of perioperative complications. However, there was a borderline significant higher incidence of anastomotic leakage among non-responders. Back

Aim: Cetuximab was administered weekly in registration clinical trials. Biweekly administration is more convenient when combining cetuximab with biweekly chemotherapy in patients with metastatic colorectal cancer (mCRC). The aim of this study is to evaluate safety and efficacy of biweekly... Read more

Aim: Cetuximab was administered weekly in registration clinical trials. Biweekly administration is more convenient when combining cetuximab with biweekly chemotherapy in patients with metastatic colorectal cancer (mCRC). The aim of this study is to evaluate safety and efficacy of biweekly cetuximab at a dose of 500 mg/m2 with chemotherapy in routine clinical practice. Methods: Clinical data of 19 consecutive patients with K-RAS wild type mCRC who received biweekly cetuximab with biweekly fluropyrimidine based chemotherapy were reviewed. Toxicity assessment was limited to the first 6 cycles of treatment. Best tumor response was assessed by an independent radiologist. Results: Median age was 59 (24-74) years. Cetuximab was administered in first, second and third line settings in 7, 9 and 3 patients respectively. Grade I/II cetuximab specific adverse events (AEs) were skin rash (47.3%), diarrhea (21%), infusion reactions (10.5%), Hypomagnesaemia (10.5%) and nail disorders (5%). Grade III AEs were skin rash (10.5%) and diarrhea (5.3%). There was no grade IV AEs. There were no complete responders. Partial response was achieved in 8 (42.1%) and stable disease in 6 (31.5%) patients. Conclusion: This small but real life experience shows that biweekly cetuximab with chemotherapy is safe and effective. The frequency of AEs compares favorably to weekly administration reported in the literature. These finding add to the relatively limited available data on biweekly administration to support its adoption in routine clinical practice. Back

Aim: Results of trial investigating addition of docetaxel (D) to androgen deprivation therapy (ADT) in patients with hormone naïve metastatic prostate cancer have been inconsistent. Thus meta-analysis is expected to settle the controversy. Methods: In this report, the authors highlight the... Read more

Aim: Results of trial investigating addition of docetaxel (D) to androgen deprivation therapy (ADT) in patients with hormone naïve metastatic prostate cancer have been inconsistent. Thus meta-analysis is expected to settle the controversy. Methods: In this report, the authors highlight the results of randomized phase III trials and the results of recently published aggregated data meta-analysis (ADM) performed by the same investigators of these trials. In addition, the authors present and discuss the results of their own independent ADM. Three randomized phase III trials were identified. Only patients with metastatic (M1) disease were included. Comprehensive meta-analysis version 3.0 was used to perform the ADM. The primary endpoint of interest was overall survival (OS). Results: The trials included a total 2,261 patients with M1 disease. Median follow up ranged between 29 and 50 months. Random effect model showed that ADT+D improved OS compared to ADT alone (Odds Ratio 0.745; 95% Confidence Interval: 0.593-0.937; P = 0.012). Conclusion: The independent ADM confirms the OS benefit of adding D to ADT in patients with hormone naïve metastatic prostate cancer. Individual patient meta-analysis is likely to identify subgroups of patients who benefit more from this approach. Back